Clear Cell Change in Eccrine Glands Is Not Associated With Diabetes

Abstract

The significance of clear cell change (clear reticulated cytoplasmic change) in the secretory portion of eccrine glands remains an enigma. It has been postulated to be a product of defective cellular glucose metabolism and potentially a predictor of diabetes. A series of 61 specimens from 38 patients were assessed to establish any demographic, seasonal, or metabolic associations. Sixty-one specimens from 38 patients with eccrine clear cell changes were identified prospectively by one of the authors (T.W.B.). Each specimen was stratified by site, age, sex, and season. For each patient, the general practitioner was contacted and diabetes status was ascertained. This was possible in 34 of 38 patients. Fifty routine consecutive cases from the archive in both summer and winter were studied for possible clear cell changes, looking for any seasonal variance. No clear association between the presence of eccrine clear cell change and any demographic or seasonal pattern was found. Specifically, there did not seem to be any significant association between diabetes and this histological finding. The prevalence of diabetes in cases with eccrine clear cell change was similar to the background population prevalence of diabetes in Australia (7.9% vs. 7.4%). The incidence of this finding is approximately 1 case in 189 specimens (0.5%) examined in this practice. Clear cell change within the secretory portion of eccrine glands seems to be an incidental finding, with no clear clinicopathological implication. In particular, there does not seem to be any association with diabetes.

Papular Clear Cell Hyperplasia of the Eccrine Duct

“…This could be related to the fact that some syringomas have been reported to express progesterone receptors, thus being more frequent in women during puberty or pregnancy. 8 However, PCCH involves the eccrine duct, and thus might be considered a different entity, not related to the clear cell changes observed in the secretory portion of the gland. 6 The clear cell changes seen in this condition, and in CCS, seem to be caused by a glycogen deposition in the cytoplasm of the cells that comprise of the eccrine duct.…”

Clear cell change in eccrine sweat glands noted in frozen section

“…While most eccrine glands have three different cell types in the secretory coil (clear cells, dark cells, and myoepithelial cells), some eccrine glands contain only clear cells, which are referred to as “clear cell change” 1 . The clear cell changes in this case were isolated to the eccrine glands and were therefore favored to represent a benign variant of normal histology.…”

“…While most eccrine glands have three different cell types in the secretory coil (clear cells, dark cells, and myoepithelial cells), some eccrine glands contain only clear cells, which are referred to as "clear cell change". 1 The clear cell changes in this case were isolated to the eccrine glands and were therefore favored to represent a benign variant of normal histology. The high glycogen content of the clear cells had previously been hypothesized to be the result of deficient glycogen phosphorylase activity such as in diabetes, 2 but Cherian et al disproved this hypothesis.…”

“…The high glycogen content of the clear cells had previously been hypothesized to be the result of deficient glycogen phosphorylase activity such as in diabetes, 2 but Cherian et al disproved this hypothesis. 1 Clear cell change in eccrine glands has been reported in 0.5% of biopsy specimens analyzed with PS. 1 To the authors' knowledge, this phenomenon has never been reported on FFS, the technique employed during MMS.…”

“…1 Clear cell change in eccrine glands has been reported in 0.5% of biopsy specimens analyzed with PS. 1 To the authors' knowledge, this phenomenon has never been reported on FFS, the technique employed during MMS. This discrepancy in prevalence of clear cell change may be related to differences in tissue processing, with superior cellular detail attainable on PS.…”